This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Stem cell therapy holds the potential to treat a range of degenerative retinal diseases, including age-related macular degeneration, the most prevalent cause of vision loss in the elderly. The aim of this project is to develop the best surgical methods and equipment for injecting therapeutic cells under the retina in a way that maximizes their survival and distribution and minimizes surgical risk. In the last year, we evaluated a series of different surgical instruments and approaches in rabbits, a species with a large eye suitable for surgical pilot work although it lacks a macula as in the primate eye. The most successful procedure used a new, custom-designed instrument that allowed fiber optic guidance of a fine-gauge catheter under the retina. The new procedure was well tolerated with minimal side effects. This method is now undergoing further refinement, and we anticipate future testing in nonhuman primates in final preparation for use in a human clinical trial.